Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Guam for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Guam only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Guam (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Government Of Guam Department Of Administration (NPI 1972577104)

Key Findings

Field	Value
Entity Type	Organization
Organization	Government Of Guam Department Of Administration
Address	520 W Santa Monica Ave
City	Dededo
State	GU
ZIP	96929
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	February 14, 2006

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

This provider is effectively single‑payer: there is no Medicare billing on file and all recorded government revenue is Medicaid only, totaling $2.4M. The absence of Medicare revenue makes the organization's reimbursement profile and financial performance highly sensitive to Medicaid policy and rate changes.

Revenue is highly concentrated in a few outpatient and immunization services: the top three Medicaid codes (99213, 90461, 99214) account for 50.9% of the provider’s total Medicaid revenue. Notably, 99213 alone represents $666.4K (28.4% of Medicaid revenue), 90461 accounts for $290.1K (12.4%), and 99214 contributes $238.3K (10.2%), indicating reliance on established‑patient E/M visits and vaccine administration for most revenue.

The code mix and volumes are consistent with an FQHC operating as a primary care and immunization hub: high counts for vaccine administration codes (90460 with 10.2K claims, $194.3K revenue; 90461 with 7.6K claims, $290.1K revenue; 90471 with 2.6K claims, $49.3K revenue) alongside preventive visit codes (99392, 99391). This pattern suggests programs targeting pediatric and population immunization services plus routine primary care, rather than specialty or acute inpatient care.

Competitive standing within the state shows leadership in vaccine throughput and low‑acuity office visits: 90461 ranks #1 of 7 (100th percentile; notably above typical state volume), 90460 ranks #1 of 8 (100th percentile; notably above typical state volume), and 99211 ranks #1 of 14 (100th percentile; notably above typical state volume). In contrast, core E/M codes 99213 (7.2K claims, $666.4K revenue) and 99214 (1.8K claims, $238.3K revenue) are described as typical, unremarkable volumes—99213 ranks #7 of 48 (87th percentile) and 99214 ranks #14 of 35 (62th percentile)—indicating the provider is a strong state actor for vaccinations and basic visits but a more modest participant for mid‑level E/M services.

Operationally, the provider appears to run a high‑volume, low‑average‑payment model for many of its services: several high‑count vaccine lines pay low per‑claim amounts (for example, 90460 averages $19 paid/claim across 10.2K claims producing $194.3K revenue). That volume-driven model supports public‑health and preventive objectives typical of an FQHC but also yields lower per‑encounter revenue relative to higher‑acuity E/M codes.

Several specific codes are flagged as statistical outliers in state comparisons, reinforcing programmatic emphasis: 90461, 90460, 99211, 0004A, 0002A, and 96127 are all described as ‘‘notably above typical state volume’’ (many rank #1 in‑state), while major E/M codes such as 99213 and 99214 are characterized as ‘‘typical, unremarkable volume.’" These labels imply the provider concentrates on certain service lines (vaccination, basic visit throughput, brief behavioral screening) relative to peers.

The provider’s NPI tenure—enumerated on 2006-02-14 (~20 years ago)—indicates a long‑standing presence in the market and suggests institutional continuity for its FQHC mission and service lines. This longevity, combined with leadership in several Medicaid codes, supports credibility as an established local safety‑net provider.

From a risk and opportunity perspective, the combination of Medicaid‑only revenue ($2.4M) and a revenue concentration (top three codes = 50.9%) creates both operational clarity and exposure: program strength is clear in vaccines and low‑acuity outpatient visits, but performance will be sensitive to any Medicaid coverage or rate changes affecting those high‑volume codes. Strategic moves that expand higher‑acuity E/M services or diversify payers could materially change the revenue mix, but current data show a program focused on preventive care and immunization delivery.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

59 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	7,240	$90	$666.4K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	7,640	$40	$290.1K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	1,850	$130	$238.3K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	10,230	$20	$194.3K
J0561	Injection, penicillin g benzathine, 100,000 units	920	$180	$162.6K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	5,500	$20	$110K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	1,790	$60	$107.2K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	980	$110	$106.3K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	790	$100	$78.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,590	$20	$49.3K

Showing 1–10 of 59

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Guam providers billing the same CPT/HCPCS codes.

Claims Volume vs. Guam Distribution

Government Of Guam Department Of Administration — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Guam

Full comparison — all codes billed, vs. Guam median

59 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	7	50	900	$80	$201.7K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	14	40	630	$90	$172.1K
J0561	Injection, penicillin g benzathine, 100,000 units	1	10	920	$180	$162.6K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	1	10	2,360	$30	$101.9K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	1	10	2,980	$20	$81.4K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	2	10	470	$110	$69.9K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	2	10	80	$100	$44.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7	10	130	$110	$42.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	4	10	60	$120	$39K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	22	20	140	$110	$35.4K

Showing 1–10 of 59

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Guam Healthcare Development Incorporated	GU	Clinic/Center	$0	$30.8M
C V Alegria Dds Inc	GU	General Practice Dentistry	$0	$11.3M
Albert Huang	GU	Dentist	$0	$5.4M
Usrc Finegayan, LLC	GU	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.5M
Renal Centers Of Guam, LLC	GU	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.1M
Maria Chela Mariano	GU	Family Medicine Physician	$0	$1.8M
Scott Shay	GU	Vascular & Interventional Radiology Physician	$1.2M	$0
Anthony Bekkerman	GU	Emergency Medicine Physician	$49.5K	$623.9K
Blue Ocean Medical Group LLC	GU	Family Medicine Physician	$0	$665.1K
Yolanda Carrera	GU	Pediatrics Physician	$0	$334.5K

Government Of Guam Department Of Administration — Billing Profile & Reimbursement Data

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Government Of Guam Department Of Administration — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References